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Unformatted text preview: 1 ILD-INTRODUCTION Interstitial lung disorders are heterogeneous group of lung disorders with variable degree of pulmonary fibrosis Diffuse parenchymal lung disease is, perhaps a more appropriate descriptive term. Incidence ranges from 3-26/1,00,000 per year. Prevalence of preclinical and undiagnosed ILD is estimated to be 10 times that of clinical recognized disease. IPF is the most common form representing at least 30 percent of the incident cases. ILD-INTRODUCTION Syndromic diagnosis with common clinical features Exertional dyspnea Bilateral diffuse infiltrates on chest radiograph Restrictive lung defects, DLCO, abnormal (PAo2-Pao2) Absence of pulmonary infection and neoplasia Histopathology: varied degrees of fibrosis and inflammation, with or without evidence of granulomatous or secondary vascular changes in pulmonary parenchyma ILD-ONSET OF SYMPTOMS Acute presentation (days to weeks) Acute idiopathic interstitial pneumonia Eosinophillic pneumonia Hypersensitive pneumonitis BOOP Sub-acute presentation (weeks to months) Sarcoidosis Drug induced ILD Alveolar hemorrhage syndromes COP CV-ILD Chronic presentation (months to years) IPF Sarcoidosis PLCH Episodic DPLDS Eosinophillic pneumonia Hypersensitivity pneumonitis Vasculitides/pulmonary hemorrhages Churg-Strauss syndrome COP 2 ILD-SYMPTOMS Respiratory symptoms Exertional dyspnea Cough nonspecific, but may be an initial complaint Cough as initial complaint raises possibility of superimposed/coexistent airway disease 1. RB-ILD 2. Sarcoidosis 3. Hypersensitivity pneumonitis 4. Pulmonary Langerhans cell histiocytosis 5. Lipoid pneumonia Productive cough long standing IPF with traction bronchiectasis ILD-SYMPTOMS Respiratory symptoms (contd) Hemoptysis Diffuse alveolar hemorrhages (33% - no hemoptysis) Lymphangioleiomyomatosis Tuberous sclerosis Pulmonary veno-occlusive disease Drugs such as D-pencillamine Known case of ILD R/o 1. Malignancy 2. Pulmonary embolism 3. Infection. ILD-SYMPTOMS Respiratory symptoms (contd) Chest pain Pleuritis SLE (50%), RA(25%)& other collagen vascular diseases Pneumothorax (40%) Substernal chest pain - sarcoidosis Wheezing Airway diseases 1. Churg-Strauss 2. Chronic eosinophillic pneumonia Endobronchial lesions 1. Sarcoidosis 2. Wegners 3. Amyloidosis 4. Inflammatory bowel disease ILD-SYMPTOMS Non Respiratory symptoms Arthritis Sarcoidosis and collagen vascular diseases Ocular Sarcoidosis, collagen vascular diseases & HLA-B27 associated diseases Skin and muscle - Polymyosistis Sicca syndrome Sarcoidosis, Sjogrens and other CVD GERD IPF and Scleroderma Lower GI symptoms Inflammatory bowel disease Recurrent sinusitis Wegners granulomatosis Neurological symptoms Sarcoidosis, Vasculitis Epilepsy & mental retardation Tuberous sclerosis Diabetes inspidus Sarcoidosis, PLCH 3...
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This note was uploaded on 12/03/2011 for the course MEDICINE 350 taught by Professor Dr.aslam during the Winter '07 term at Medical College.
- Winter '07